Sunday, July 25, 2004

Dying To See A Doctor

Here's a great read from Walter Williams over at townhall .  

The Fraser Institute, a Vancouver, B.C.-based think tank, has done yeoman's work keeping track of Canada's socialized health-care system. It has just come out with its 13th annual waiting-list survey. It shows that the average time a patient waited between referral from a general practitioner to treatment rose from 16.5 weeks in 2001-02 to 17.7 weeks in 2003. Saskatchewan had the longest average waiting time of nearly 30 weeks, while Ontario had the shortest, 14 weeks.

 Waiting lists also exist for diagnostic procedures such as computer tomography (CT), magnetic resonance imaging (MRI) and ultrasound. Depending on what province and the particular diagnostic procedure, the waiting times can range from two to 24 weeks.  
  So, after getting a referral, patients are waiting an average of 4.5 months before being treated by a specialist.  Not sure, but I think indigent patients in my part of the country can get an appt with a neurologist in less than 18 weeks.  Certaily demonstrates how bad the Canuck system is.

As reported in a December 2003 story by Kerri Houston for the Frontiers of Freedom Institute titled "Access Denied: Canada's Healthcare System Turns Patients Into Victims," in some instances, patients die on the waiting list because they become too sick to tolerate a procedure. Houston says that hip-replacement patients often end up non-ambulatory while waiting an average of 20 weeks for the procedure, and that's after having waited 13 weeks just to see the specialist. The wait to get diagnostic scans followed by the wait for the radiologist to read them just might explain why Cleveland, Ohio, has become Canada's hip-replacement center.
  But, but, it's free.  And really, this is the fault of the doctors, not the Canadian HealthCare system.  If the doctors would work harder, and more doctors would graduate, then this sort of lag wouldn't occur.  Which leads us to ...

Adding to Canada's medical problems is the exodus of doctors. According to a March 2003 story in Canada News (http://www.canoe.ca/), about 10,000 doctors left Canada during the 1990s. Compounding the exodus of doctors is the drop in medical school graduates. According to Houston, Ontario has chosen to turn to nurses to replace its bolting doctors. It's "creating" 369 new positions for nurse practitioners to take up the slack for the doctor shortage.
  Anyone want to venture a guess as to why doctors are leaving the Canadian system in droves?  Could it be that they get screwed harder than a dirty Thai hooker? 

Some patients avoided long waits for medical services by paying for private treatment. In 2003, the government of British Columbia enacted Bill 82, an "Amendment to Strengthen Legislation and Protect Patients." On its face, Bill 82 is to "protect patients from inadvertent billing errors." That's on its face. But according to a January 2004 article written by Nadeem Esmail for the Fraser Institute's Forum and titled "Oh to Be a Prisoner," Bill 82 would disallow anyone from paying the clinical fees for private surgery, where previously only the patients themselves were forbidden from doing so. The bill also gives the government the power to levy fines of up to $20,000 on physicians who accept these fees or allow such a practice to occur. That means it is now against Canadian law to opt out of the Canadian health-care system and pay for your own surgery.
  Making it illegal to opt out is about the only way to support such a corrupt and broken system.  God help the US if our beloved policiticans cave into socialist demands for a system in the same vein as what Canada is cursed with.

Health care can have a zero price to the user, but that doesn't mean it's free or has a zero cost. The problem with a good or service having a zero price is that demand is going to exceed supply. When price isn't allowed to make demand equal supply, other measures must be taken. One way to distribute the demand over a given supply is through queuing -- making people wait. Another way is to have a medical czar who decides who is eligible, under what conditions, for a particular procedure -- for example, no hip replacement or renal dialysis for people over 70 or no heart transplants for smokers.

 I'm wondering just how many Americans would like Canada's long waiting lists, medical czars deciding what treatments we get and an exodus of doctors.
  Simple answer to this question: only the die-hard leftists, and even they would reject it once they themselves got sick.



Friday, July 23, 2004

Call Your Senator, US Generics Cheaper Than Canadian counterparts

Isn't this interesting. Or, if you're a SNL fan, "isn't dat speshul"!

Some tidbits:

FDA analysts looked at the seven biggest-selling generic prescription drugs for chronic conditions that became available as generics in the United States since 1993....

For six of the seven drugs, the U.S. generics were priced lower than the brand-name versions in Canada . Five of the seven U.S. generic drugs were also cheaper than the Canadian generics. Of the remaining two U.S. generic drugs, one (enalapril) was unavailable in Canada generically, and its Canadian brand-name version was more than five times the price of the U.S. generic equivalent. The other U.S. generic (metformin) sold for less in Canada both as a generic and as a brand name. Metformin did not become available generically in the United States until January 2002, so U.S. generic prices have likely not fallen to the level they will eventually reach, say the FDA Office of Planning economists who did the study.
A limited sample to be sure, but quite helpful nonetheless when dealing with a "big pharma is destroying my budget" simpleton.

Advocates of legalizing imports of drugs from Canada and other countries have typically cited studies showing that brand-name drugs are much cheaper abroad than in the United States . These studies ignore how competition in the U.S. market lowers generic drug prices so they are lower than drug prices abroad, say FDA economists. U.S. generics have the same quality, safety, and strength as brand-name drugs, and they undergo the same rigorous review by the FDA before they are allowed on the market.
Advocates of reimportation ignore such things because it hurts their already weak argument.

Suffice it to say, Americans pay for access to the best drugs earlier than other countries. Is that worth the premium? Ask Canadians or other foreign citizens who are still awaiting escitalopram, geodon, etc. and instead are being subjected to desipramine for bipolar disorder. Americans pay for the most stringent safety standards. Is that worth the premium? Ask foreigners who have developed tardive dyskinesia from constant usage of thorazine in a country that did not label side effects or dosages correctly.

A premium is paid, for a short period of time before the market kicks in when a generic is developed, but ask yourself whether that premium is worth it. If you think your drugs cost too much, think of the costs involved with not getting those meds.

Tuesday, July 13, 2004

Rape Victims Forcing Rapists To Wear Condoms

Flipping through the news for today, I ran across this little gem.

U.S. Congresswoman Barbara Lee, the only member of Congress to attend the week-long meeting, accused the Bush administration of using ideology, not science, to dictate policy.

She said the U.S. AIDS initiative requires that one-third of prevention funding go to "abstinence until marriage" programs.

"In an age where five million people are newly infected each year and women and girls too often do not have the choice to abstain, an abstinence until marriage program is not only irresponsible, it's really inhumane," Lee said.

"Abstaining from sex is oftentimes not a choice, and therefore their only hope in preventing HIV infection is the use of condoms," she added.
I had to read the above segment 3 times before moving on. It's the sort of idiotic nonsense that really makes you wonder how these individuals end up as our representatives in government bodies.

"Abstaining from sex is oftentimes not a choice, and therefore their only hope in preventing HIV infection is the use of condoms"

Does this make any sense? If she's talking about rape, what are the chances that some rapist is going to stop midstream to put on a condom? If she's talking sexual abuse by family member, what are the odds said family member will stop midstream? Does Congresswoman Lee advocate women carrying rubbers in their pockets in the off-chance someone decides to pull them aside and rape them?

If she's not talking about some sort of forced intercourse, rape or otherwise, then how does she arrive @ "abstaining from sex is oftentimes not a choice"? I know quite a few females who are quite adamant about their CHOICE to not partake in sexual relations. Perhaps Ms. Lee understands something of which I am unaware with regards to women not having a choice when it comes to sexual intercourse.

Quick comment on the rest of the article: Of course abstinence is the most effective way to reduce HIV transmission. Anyone who says otherwise is attempting to sell condoms. Are kids likely to remain abstinent, probably not. This does not mean programs should give up teaching abstinence in favor of the 'We know you're gonna fukk, so take a box of condoms and be safe' mantra so pervasive during the 90s. Uganda has the correct order: A(bstinence), B(eing Faithful), and C(ondoms). Even a toddler could understand the importance of that order.

Saturday, July 10, 2004

Health Care A Right?

Over @ Balloon-Juice is a post regarding recent trends by physicians to deny non-emergency care to trial lawyers and others associated with medical malpractice suits. Since health care is not a human right, doctors are correct in deciding not to treat lawyers. Even if this trend were to catch on, my opinion is that enough physicians would exist to still care for those previously refused care.

Some interesting reading on the subject, see here, here, and here.

I'd be interested in logical reasons for including health care is a 'right', eventhough it is not found in the Constitution and actually steps on the rights of health care providers if invoked. Please comment.

Wednesday, July 07, 2004

Cheney MD A Pill Popper

Now this is the sort of stuff I love to read about physicians.

Vice President Dick Cheney's personal doctor, who four years ago declared Mr. Cheney "up to the task of the most sensitive public office" despite a history of heart disease, was battling an addiction to prescription drugs at the time and has recently been dropped from the vice president's medical team, according to officials at the hospital where he practiced.

The doctor, Gary Malakoff of George Washington University Medical Center, had treated Mr. Cheney since 1995 and been a prominent spokesman on the vice president's health. He also reviewed the medical records of Vice President Al Gore during the 2000 campaign, but did not see Mr. Gore as a patient.
So we have a physician self-medicating. Hardly newsworthy, except that this man treats the VP of the United States, and stated a few years ago that even with heart problems, Cheney was fit for an arguably stressful position.

Hospital officials said Sunday that they had known since 1999 of Dr. Malakoff's problem, and that Dr. Malakoff informed the vice president at that time or in 2000. But he was permitted to continue working, they said, while undergoing treatment and monitoring, including urine tests, by an independent board.
Interesting. The hospital had known said physician was an addict self-medicating, and instead of throwing his ass out he was treated. Now, I'm all for treating addicts as that is 10000x better than throwing them in prison. However, allowing an physician to continue to practice whilst undergoing treatment for addiction appears rather stupid. I mean hell, the guy didn't even lose his spot as director of general internal medicine @ George Washington.

But in May, when the board concluded that Dr. Malakoff was too impaired to care for patients, he was relieved of his position as director of the medical center's general internal medicine division, they said. He is on leave until September, and could not be reached Sunday for comment.
How did they finally come to that conlcusion? Did he happen to undergo withdrawal symptoms while taking an H&P? Maybe he stole some samples destined for an elderly ICU patient? Maybe he simply pissed off his nurse who decided to stop covering for his ass. We'll likely never know.

The point is that, while not completely rampant within the profession, this occurs more often than it should. I'm not just referring to doctors self-medicating, but administrators and nurses covering for said physician. Sort of difficult to help others if you're on cloud9 thanks to a stash of diazepam. Hell, this guy was high profile and kept his job 5 years after everyone knew of his problem. Imagine what a no-name physician in a rural area can get away with.

Are People Really This Stupid?

According to the following, the US of A needs a helping hand in ensuring democracy reigns within our borders. Read the article, then decide what party you believe the 9 representatives are from. Here's a hint, their party affiliation is never mentioned once within the article.

WASHINGTON (AFP) - Several members of the House of Representatives have requested the United Nations (news - web sites) to send observers to monitor the November 2 US presidential election to avoid a contentious vote like in 2000, when the outcome was decided by Florida.

Recalling the long, drawn out process in the southern state, nine lawmakers, including four blacks and one Hispanic, sent a letter Thursday to UN Secretary General Kofi Annan (news - web sites) asking that the international body "ensure free and fair elections in America," according to a statement issued by Florida representative Eddie Bernice Johnson, who spearheaded the effort.

"As lawmakers, we must assure the people of America that our nation will not experience the nightmare of the 2000 presidential election," she said in the letter.

"This is the first step in making sure that history does not repeat itself," she added after requesting that the UN "deploy election observers across the United States" to monitor the November, 2004 election.